{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T18:13:51Z","timestamp":1791483231511,"version":"4.3.4"},"reference-count":53,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2020,12,13]],"date-time":"2020-12-13T00:00:00Z","timestamp":1607817600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["FIS-PI18\/00912"],"award-info":[{"award-number":["FIS-PI18\/00912"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010774","name":"Consejer\u00eda de Educaci\u00f3n e Investigaci\u00f3n","doi-asserted-by":"publisher","award":["B2017\/BMD-3804 MITIC-CM"],"award-info":[{"award-number":["B2017\/BMD-3804 MITIC-CM"]}],"id":[{"id":"10.13039\/501100010774","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Postpartum depression (PPD) affects 13% of mothers and can have a major impact on their lives and those of their children. However, most cases go undiagnosed, and the risk factors for this underdiagnosis are not yet fully known. We intended to analyze the influence of different sociodemographic and health factors associated with symptoms of postpartum depression. Data from the New York City Pregnancy Risk Assessment Monitoring System (PRAMS) for 2016\u20132017 were analyzed. 618 women met the inclusion criterion of recurring depressive symptoms. Most women who experienced PPD symptoms did not seek help. Seeking help was a much better predictor of the diagnosis of PPD when compared to questions regarding symptoms. The most important factors related to a decreased risk of not asking for help were having a previous mental health history and having doctor visits for a chronic illness. The racial group most at risk of not asking for help were Asian\/Pacific Islander (API) women. Interventions aimed at reducing the stigma and increasing knowledge of PPD should be incorporated into the antenatal education of expectant mothers, particularly among women who may not have previously sought care for mental or chronic illnesses.<\/jats:p>","DOI":"10.3390\/ijerph17249328","type":"journal-article","created":{"date-parts":[[2020,12,13]],"date-time":"2020-12-13T23:39:36Z","timestamp":1607902776000},"page":"9328","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":53,"title":["Factors Related to Seeking Help for Postpartum Depression: A Secondary Analysis of New York City PRAMS Data"],"prefix":"10.3390","volume":"17","author":[{"given":"Silvia","family":"Manso-C\u00f3rdoba","sequence":"first","affiliation":[{"name":"Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcal\u00e1, Alcal\u00e1 de Henares, 28801 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Pickering","sequence":"additional","affiliation":[{"name":"Graduate School of Public Health and Health Policy, City University of New York (CUNY), New York, NY 10010, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2588-1708","authenticated-orcid":false,"given":"Miguel A.","family":"Ortega","sequence":"additional","affiliation":[{"name":"Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcal\u00e1, Alcal\u00e1 de Henares, 28801 Madrid, Spain"},{"name":"Ram\u00f3n y Cajal Institute of Healthcare Research (IRYCIS), 28034 Madrid, Spain"},{"name":"University Center for the Defense of Madrid (CUD-ACD), 28047 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7898-4685","authenticated-orcid":false,"given":"\u00c1ngel","family":"As\u00fansolo","sequence":"additional","affiliation":[{"name":"Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcal\u00e1, Alcal\u00e1 de Henares, 28801 Madrid, Spain"},{"name":"Ram\u00f3n y Cajal Institute of Healthcare Research (IRYCIS), 28034 Madrid, Spain"},{"name":"Department of Community Health and Social Sciences, City University of New York (CUNY) Graduate School of Public Health and Health Policy, New York, NY 10010, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4832-9564","authenticated-orcid":false,"given":"Diana","family":"Romero","sequence":"additional","affiliation":[{"name":"Department of Community Health and Social Sciences, City University of New York (CUNY) Graduate School of Public Health and Health Policy, New York, NY 10010, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,12,13]]},"reference":[{"key":"ref_1","unstructured":"WHO (2020, December 13). Mental Health and Substance Use. Available online: https:\/\/www.who.int\/mental_health\/maternal-child\/maternal_mental_health\/en\/."},{"key":"ref_2","unstructured":"WHO (2020, December 13). Mental Health and Substance Use. Available online: https:\/\/www.who.int\/mental_health\/prevention\/suicide\/lit_review_postpartum_depression.pdf."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/HRP.0000000000000013","article-title":"The Course of Postpartum Depression","volume":"22","author":"Vliegen","year":"2014","journal-title":"Harv. Rev. Psychiatry"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1001\/jamapsychiatry.2013.87","article-title":"Onset timing, thoughts of self-harm, and diagnoses in postpartum women with screen-positive depression findings","volume":"70","author":"Wisner","year":"2013","journal-title":"JAMA Psychiatry"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.jpsychires.2015.04.021","article-title":"Suicidal ideation in depressed postpartum women: Associations withchildhood trauma, sleep disturbance and anxiety","volume":"66\u201367","author":"Sit","year":"2015","journal-title":"J. Psychiatr. Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1192\/bjp.183.4.279","article-title":"Suicide: The leading cause of maternal death","volume":"138","author":"Oates","year":"2003","journal-title":"Br. J. Psychiatry"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1093\/bmb\/ldg011","article-title":"Perinatal psychiatric disorders: A leading cause of maternal morbidity and mortality","volume":"67","author":"Oates","year":"2003","journal-title":"Br. Med. Bull."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1136\/bmj.292.6529.1165","article-title":"Impact of maternal postnatal depression on cognitive development of young children","volume":"292","author":"Robson","year":"1986","journal-title":"Br. Med. J. (Clin. Res. Ed.)"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1093\/pch\/9.8.575","article-title":"Maternal depression and child development","volume":"9","year":"2004","journal-title":"Paediatr. Child Health"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"(2004). Depression in pregnant women and mothers: How children are affected. Paediatr. Child Health, 9, 584\u2013586.","DOI":"10.1093\/pch\/9.8.584"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1159\/000358838","article-title":"Low serum allopregnanolone is associated with symptoms of depression in late pregnancy","volume":"69","author":"Hellgren","year":"2014","journal-title":"Neuropsychobiology"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1016\/j.psyneuen.2017.02.012","article-title":"Lower allopregnanolone during pregnancy predicts postpartum depression: An exploratory study","volume":"79","author":"Osborne","year":"2017","journal-title":"Psychoneuroendocrinology"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1058","DOI":"10.1016\/S0140-6736(18)31551-4","article-title":"Brexanolone injection in post-partum depression: Two multicentre, double-blind, randomised, placebo-controlled, phase 3 trials","volume":"392","author":"Colquhoun","year":"2018","journal-title":"Lancet"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"American Medical Association (2019). Brexanolone (Zulresso) for Postpartum Depression. JAMA, 322, 73\u201374.","DOI":"10.1001\/jama.2019.6622"},{"key":"ref_15","unstructured":"FDA (2020, December 13). FDA Approves First Treatment for Post-Partum Depression, Available online: https:\/\/www.fda.gov\/news-events\/press-announcements\/fda-approves-first-treatment-post-partum-depression."},{"key":"ref_16","unstructured":"Baby Center (2020, December 13). More than Just Baby Blues: 1400 Moms Talk about Postpartum Depression. Available online: https:\/\/www.babycenter.com\/0_more-than-just-baby-blues-1-400-moms-talk-about-postpartum-d_10399286.bc."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1080\/14034940510005725","article-title":"\u201cStruggling with life\u201d: Narratives from women with signs of postpartum depression","volume":"33","author":"Edhborg","year":"2005","journal-title":"Scand. J. Public Health"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1037\/0003-066X.59.7.614","article-title":"How stigma interferes with mental health care","volume":"59","author":"Corrigan","year":"2004","journal-title":"Am. Psychol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1097\/01.NMD.0000066157.47101.22","article-title":"Mental illness stigma and care seeking","volume":"191","author":"Cooper","year":"2003","journal-title":"J. Nerv. Ment. Dis."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1080\/09638230500271097","article-title":"A qualitative study of stigma among women suffering postnatal illness","volume":"14","author":"Edwards","year":"2005","journal-title":"J. Ment. Health"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1599","DOI":"10.1007\/s10995-012-1171-z","article-title":"Rates and predictors of postpartum depression by race and ethnicity: Results from the 2004 to 2007 New York city PRAMS survey (pregnancy risk assessment monitoring system)","volume":"17","author":"Liu","year":"2013","journal-title":"Matern. Child Health J."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Ibrahim, N., Amit, N., Shahar, S., Wee, L.H., Ismail, R., Khairuddin, R., Sin Siau, C., and Mohd Safien, A. (2019). Do depression literacy, mental illness beliefs and stigma influence mental health help-seeking attitude? A cross-sectional study of secondary school and university students from B40 households in Malaysia. BMC Public Health, 19.","DOI":"10.1186\/s12889-019-6862-6"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1080\/09638237.2019.1581342","article-title":"Mental health literacy and help-seeking among unemployed people with mental health problems","volume":"29","author":"Waldmann","year":"2019","journal-title":"J. Ment. Health"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1442","DOI":"10.1097\/01.AOG.0000164050.34126.37","article-title":"Racial and ethnic differences in factors associated with early postpartum depressive symptoms","volume":"105","author":"Howell","year":"2005","journal-title":"Obstet. Gynecol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1007\/s10995-007-0287-z","article-title":"Postpartum depression: Racial differences and ethnic disparities in a tri-racial and bi-ethnic population","volume":"12","author":"Wei","year":"2008","journal-title":"Matern. Child Health J."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1176\/ps.62.6.pss6206_0619","article-title":"Racial and Ethnic Disparities in Postpartum Depression Care Among Low-Income Women","volume":"62","author":"Kozhimannil","year":"2011","journal-title":"Psychiatr. Serv."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1097\/JGP.0b013e318227f876","article-title":"Cultural beliefs and mental health treatment preferences of ethnically diverse older adult consumers in primary care","volume":"20","author":"Jimenez","year":"2012","journal-title":"Am. J. Geriatr. Psychiatry"},{"key":"ref_28","first-page":"288","article-title":"Factors That Influence the Diagnoses of Asian Americans in Mental Health: An Exploration","volume":"49","author":"Kwok","year":"2013","journal-title":"Perspect. Psychiatr. Care"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"805","DOI":"10.2105\/AJPH.91.5.805","article-title":"Racial\/Ethnic differences in attitudes toward seeking professional mental health services","volume":"91","author":"Diala","year":"2001","journal-title":"Am. J. Public Health"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1002\/nur.20344","article-title":"African american women\u2019s beliefs about mental illness, stigma, and preferred coping behaviors","volume":"32","author":"Ward","year":"2009","journal-title":"Res. Nurs. Health"},{"key":"ref_31","unstructured":"SAMHSA (2015). Racial\/Ethnic Differences in Mental Health Service Use among Adults, SAMHSA."},{"key":"ref_32","unstructured":"Colorlines (2020, December 13). The Paradox of Postpartum Depression. Available online: https:\/\/www.colorlines.com\/articles\/paradox-postpartum-depression."},{"key":"ref_33","unstructured":"(2020, December 13). Shots\u2014Health News: NPR. Black Mothers Get Less Treatment For Their Postpartum Depression. Available online: https:\/\/www.npr.org\/sections\/health-shots\/2019\/11\/29\/760231688\/black-mothers-get-less-treatment-for-their-postpartum-depression?t=1582550315920."},{"key":"ref_34","unstructured":"CDC (2020, December 13). PRAMS Methodology, Available online: https:\/\/www.cdc.gov\/prams\/methodology.htm."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1624\/105812409X426305","article-title":"Postpartum Depression: How Childbirth Educators Can Help Break the Silence","volume":"18","author":"Zauderer","year":"2009","journal-title":"J. Perinat. Educ."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"e5851","DOI":"10.1097\/MD.0000000000005851","article-title":"The association between pregnancy intendedness and experiencing symptoms of postpartum depression among new mothers in the United States, 2009 to 2011: A secondary analysis of PRAMS data","volume":"96","author":"Gauthreaux","year":"2017","journal-title":"Medicine"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1016\/j.amepre.2015.09.027","article-title":"Racial\/Ethnic Differences in Unintended Pregnancy: Evidence from a National Sample of U.S. Women","volume":"50","author":"Kim","year":"2016","journal-title":"Am. J. Prev. Med."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Moseson, H., Mahanaimy, M., Dehlendorf, C., and Gerdts, C. (2019). \u201c\u2026Society is, at the end of the day, still going to stigmatize you no matter which way\u201d: A qualitative study of the impact of stigma on social support during unintended pregnancy in early adulthood. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0217308"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Azale, T., Fekadu, A., and Hanlon, C. (2016). Treatment gap and help-seeking for postpartum depression in a rural African setting. BMC Psychiatry, 16.","DOI":"10.1186\/s12888-016-0892-8"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.jmwh.2008.07.003","article-title":"Postpartum Depression and Help-Seeking Behavior","volume":"54","author":"McGarry","year":"2009","journal-title":"J. Midwifery Women\u2019s Health"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Augsberger, A., Yeung, A., Dougher, M., and Hahm, H.C. (2015). Factors influencing the underutilization of mental health services among Asian American women with a history of depression and suicide. BMC Health Serv. Res., 15.","DOI":"10.1186\/s12913-015-1191-7"},{"key":"ref_42","unstructured":"(2020, December 13). Poblaci\u00f3n (Espa\u00f1oles\/Extranjeros) por Pa\u00eds de Nacimiento, Sexo y A\u00f1o. Available online: https:\/\/www.ine.es\/jaxi\/Tabla.htm?path=\/t20\/e245\/p08\/l0\/&file=01006.px&L=0."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1111\/j.1365-2850.2011.01783.x","article-title":"The experience of young people with depression: A qualitative study","volume":"19","author":"Mccann","year":"2012","journal-title":"J. Psychiatr. Ment. Health Nurs."},{"key":"ref_44","first-page":"281","article-title":"Valoraci\u00f3n de la calidad de vida, estigma social y adhesi\u00f3n al tratamiento en pacientes con epilepsia del \u00c1rea de Salud de C\u00e1ceres: Estudio transversal","volume":"67","year":"2018","journal-title":"Rev. Neurol."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Taylor, A.G., Adelstein, K.E., Fischer-White, T.G., Murugesan, M., and Anderson, J.G. (2016). Perspectives on Living with Fibromyalgia. Glob. Qual. Nurs. Res., 3.","DOI":"10.1177\/2333393616658141"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1016\/S2055-6640(20)30332-0","article-title":"HIV disclosure and stigma among women living with HIV in Denmark","volume":"3","author":"Wessman","year":"2017","journal-title":"J. Virus Erad."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1007\/s10865-012-9422-4","article-title":"Development and psychometric evaluation of the Chronic Illness Anticipated Stigma Scale","volume":"36","author":"Earnshaw","year":"2013","journal-title":"J. Behav. Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.yebeh.2017.01.033","article-title":"The experience of epilepsy in later life: A qualitative exploration of illness representations","volume":"70","author":"Yennadiou","year":"2017","journal-title":"Epilepsy Behav."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1176\/appi.ajp.158.3.479","article-title":"Perceived stigma as a predictor of treatment discontinuation in young and older outpatients with depression","volume":"158","author":"Sirey","year":"2001","journal-title":"Am. J. Psychiatry"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1007\/s00737-013-0369-4","article-title":"Women\u2019s perspectives on postpartum depression screening in pediatric settings: A preliminary study","volume":"16","author":"Byatt","year":"2013","journal-title":"Arch. Womens Ment. Health"},{"key":"ref_51","unstructured":"(2020, December 13). Screening Recommendations. Available online: https:\/\/www.aap.org\/en-us\/advocacy-and-policy\/aap-health-initiatives\/Screening\/Pages\/Screening-Recommendations.aspx."},{"key":"ref_52","unstructured":"(2020, December 13). Edinburgh Postnatal Depression Scale. Available online: https:\/\/psychology-tools.com\/test\/epds."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, American Psychiatric Association.","DOI":"10.1176\/appi.books.9780890425596"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/24\/9328\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:44:32Z","timestamp":1760179472000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/24\/9328"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,13]]},"references-count":53,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2020,12]]}},"alternative-id":["ijerph17249328"],"URL":"https:\/\/doi.org\/10.3390\/ijerph17249328","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,13]]}}}